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James O’Dell, M.D. |
“Rheumatoid arthritis is still a crippling disease,” said James O’Dell, M.D., UNMC professor of internal medicine and chief of the rheumatology and immunology section. “Up to one third of patients can’t work five years after they’re diagnosed because they become physically disabled. If we knew more about what causes RA, we could intervene sooner. We could prevent the painful and disabling joint deformities that afflict so many patients.”
Identifying the causes of rheumatoid arthritis is the focus of a new study at UNMC, under Dr. O’Dell’s leadership. The five-year study is called SERA — Studies of the Etiology of Rheumatoid Arthritis. SERA is funded by a National Institutes of Health grant and includes four networks — one based at UNMC. The principal investigator for SERA is Mike Holers, M.D., of the University of Colorado.
Dr. O’Dell is principal investigator for the UNMC-based RAIN network, a consortium of 10 rheumatology clinics in the Midwest. As one of this country’s leading clinical investigators in rheumatology, Dr. O’Dell conducts about six clinical studies per year using the RAIN network as his base of patients.
The population base for the SERA study is different because it involves healthy individuals.
“Candidates for this study are family members of patients with rheumatoid arthritis,” he said. “They must be first-degree relatives — mothers, fathers, brothers, sisters or children (at least 18 years old) who do not already have RA. These patients will help us find out what triggers RA.”
More than 2 million Americans have rheumatoid arthritis, and nearly 70 percent are female. Though little is known about the specific causes, most scientists believe both genetics and the environment play a role.
Something in the environment may trigger a faulty gene, causing the immune system to attack its own tissues — it’s called an auto-immune response. In rheumatoid arthritis, the immune system promotes inflammation of the joints, leading to joint deformity and functional disability.
One component of SERA is to more accurately identify the genetic biomarkers that create the auto-immune susceptibility.
“We already know certain biomarkers create a tendency for someone to develop RA but most people with these genes never get the disease,” Dr. O’Dell said. “We’re searching for new biomarkers and studying the ones we already know about, and we hope to identify a specific combination of biomarkers to help us predict who will develop rheumatoid arthritis.”
Dr. O’Dell said another part of the study involves looking for autoantibodies in the blood, which sometimes show up years before symptoms develop.
“The earlier you begin treatment the better the outcome,” he said. “In the near future we hope to begin therapy even before symptoms start.”
SERA also is designed to uncover potential environmental factors, such as smoking or exposure to infection, which may play a role in triggering rheumatoid arthritis.
“Discovering the genetic and environmental triggers would give us a huge advantage,” Dr. O’Dell said. “We hope to be able to diagnose RA sooner and create better outcomes for patients. In the future, we might even be able to prevent rheumatoid arthritis from occurring. That’s our goal.”
Patients who join the SERA study will have a one-time clinic visit, which includes a blood draw, urine analysis and a joint exam. Study patients also must answer two extensive questionnaires regarding environmental exposures, diet and medical history.
For more information about the SERA study, call 402-559-4873.